alexa Prediction of Defibrillation Outcome by Ventricular Fibrillation Waveform Analysis: A Clinical Review
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
Open Access

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Review Article

Prediction of Defibrillation Outcome by Ventricular Fibrillation Waveform Analysis: A Clinical Review

Mi He, Bihua Chen, Yushun Gong, Kaifa Wang, and Yongqin Li*
School of Biomedical Engineering, Third Military Medical University and Chongqing University, Chongqing, China
Corresponding Author : Yongqin Li, MSBME, PhD
School of Biomedical Engineering
Third Military Medical University and Chongqing University
30 Gaotanyan Main Street, Chongqing, China 400038
Tel: (023) 6877-2483
Fax: (023) 6877-1257
Received April 29, 2013; Accepted June 13, 2013; Published June 15, 2013
Citation: Mi He, Chen B, Gong Y, Wang K, Li Y (2013) Prediction of Defibrillation Outcome by Ventricular Fibrillation Waveform Analysis: A Clinical Review. J Clinic Experiment Cardiol S10:009. doi:10.4172/2155-9880.S10-009
Copyright: © 2013 Mi He, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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The most frequent initial rhythm in out-of-hospital witnessed cardiac arrest is ventricular fibrillation (VF) and electrical defibrillation is still the only effective therapy for the termination of this life-threatening cardiac arrhythmia. Even though earlier defibrillation is greatly emphasized during cardiopulmonary resuscitation (CPR), unnecessary or repetitive high energy defibrillations are associated with decreased post-resuscitation myocardial function. Optimizing the timing of defibrillation is of great importance in order to discriminate patients should receive immediate defibrillation versus alternate therapies such as CPR. Since characteristics of VF waveform changes over time and with CPR, which exhibit predictable ability of defibrillation success, quantitative analysis of VF waveform has the potential to guide defibrillation. This article reviewed methods developed for VF waveform analysis (including time domain, frequency domain, time-frequency domain, nonlinear analysis, and combination analysis techniques) and their performances for the prediction of defibrillation outcomes in clinical settings. The retrospective meta-analysis confirmed that VF waveform could predict the return of organized electrical activity, restoration of spontaneous circulation, and survival reliably. Additionally, predictors based on time-frequency and nonlinear methods were superior to other methods on the whole. However, no prospective studies have been performed to identify the optimal time of defibrillation utilizing VF waveform analysis until now. Therefore, the value of VF waveform analysis to guide clinical countershock management still needs further investigation.

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